WithanE
Designs
Order Form
To order, print this page, complete the form and mail to: WithanE Designs, 1102 Welcome Ave. N, Golden Valley, MN 55422. Orders over $50 must include 50% of total bill. The remainder, including sales tax and shipping charges, will be billed upon delivery.
All glass is variable and may include iridized, colored, baroque and/or confetti glass. You may specify a type of glass or general color scheme (green, blue, red, pink, etc.) in the Glass/Colors column below, and I will make every effort to honor your request. Please be as specific as possible (light blue, cobalt blue, turquoise blue, etc.) if this is important to you.
Billing Information |
Shipping Information (if different from Billing) |
Name: | Name: |
Address: | Address: |
Telephone: | Email: |
Item (Circle Preference) |
Glass/Colors |
Price/ unit |
Quantity |
Total |
House Shaped Feeder: Wedge/Curve | $50.00 | |||
Gazebo Feeder | $80.00 | |||
Bird House: Chickadee/Wren | $50.00 | |||
Large Fly-Through Feeder | $90.00 | |||
Small Fly-Through Feeder | $60.00 | |||
Oriole Feeder | $45.00 | |||
Decorative Bird House: Wren/Chickadee/Bluebird | $50.00 | |||
Bevel Glass Boxes | $40.00 | |||
Total amount of order: | $ |
Total enclosed: | $ |
Functional garden art. For you. For a gift. For the birds.
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